Cancer patients undergoing chemotherapy frequently experience anticipatory distress before treatment sessions. Eighty-six cancer patients (ovarian, lymphoma and breast) were assessed to determine the prevalence of anticipatory nausea and vomiting (ANV). Approximately one patient in three reported anticipatory nausea (AN), and of these 6 also experienced anticipatory vomiting (AV). Several patients reported anticipatory anxiety without any sensation of nausea. Clinically the notion of anticipatory distress may be more fruitful so that the problem of pretreatment anxiety is also addressed. Generally, AN was rated as moderate or worse in severity, occurred fairly consistently, and often began well before arrival at hospital on treatment day. It is suggested that future research should endeavour to link more closely the topography of the problem and the intervention techniques employed, as well as evaluating a broader range of possible interventions.